[Acid-base balance during exchange transfusion (author's transl)]

During exchange transfusion with ACD blood severe metabolic acidosis may occur. ACD blood contains increasing amounts of acid which depends on the age of the blood. The mature newborn infant has different ways to compensate metabolic acidosis: the lungs, the immature kidneys and the conversion of citrate to bicarbonate. In preterm infants as well as in newborns with respiratory distress syndrome and mechanical ventilation the compensatory mechanisms may be reduced or even absent. Therefore ACD blood may lead to severe complications. To prevent acidosis adequate buffering with TRIS is recommended.